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Austin AE, DePadilla L, Niolon P, Stone D, Bacon S. Intersection of adverse childhood experiences, suicide and overdose prevention. Inj Prev 2024:ip-2024-045295. [PMID: 39053926 DOI: 10.1136/ip-2024-045295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/11/2024] [Indexed: 07/27/2024]
Abstract
Adverse childhood experiences (ACEs), suicide and overdose are linked across the life course and across generations and share common individual-, interpersonal-, community- and societal-level risk factors. The purpose of this review is to summarise the shared aetiology of these public health issues, synthesise evidence regarding potential community- and societal-level prevention strategies and discuss future research and practice directions.Growing evidence shows the potential for community- and societal-level programmes and policies, including higher minimum wage; expanded Medicaid eligibility; increased earned income tax credits, child tax credits and temporary assistance for needy families benefits; Paid Family Leave; greater availability of affordable housing and rental assistance; and increased participation in the Supplemental Nutrition Assistance Program (SNAP), to contribute to ACEs, suicide and overdose prevention. Considerations for future prevention efforts include (1) expanding the evidence base through rigorous research and evaluation; (2) assessing the implications of prevention strategies for equity; (3) incorporating a relational health perspective; (4) enhancing community capacity to implement, scale and sustain evidenced-informed prevention strategies; and (5) acknowledging that community- and societal-level prevention strategies are longer-term strategies.
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Affiliation(s)
- Anna E Austin
- Centers for Disease Control and Prevention National Center for Injury Prevention and Control, Atlanta, Georgia, USA
| | | | - Phyllis Niolon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Sarah Bacon
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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2
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Arora K, Wolf DA. Paid Leave Mandates and Care for Older Parents. Milbank Q 2024. [PMID: 38899473 DOI: 10.1111/1468-0009.12708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/03/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Policy Points We examined the effect of the Paid Family Leave policy (PFL) and Paid Sick Leave policy (PSL) on care provision to older parents. We found that PSL adoption led to an increase in care provision, an effect mainly attributable to respondents in states/periods when PSL and PFL were concurrently offered. Some of the strongest effects were found among women and unpartnered adult children. PFL adoption by itself was not associated with care provision to parents except when PFL also offered job protection. Paid leave policies have heterogeneous effects on eldercare and their design and implementation should be carefully considered. CONTEXT Family caregivers play a critical role in the American long-term care system. However, care responsibilities are known to potentially conflict with paid work, as about half of family caregivers are employed. The federal Family and Medical Leave Act passed by the US Congress in 1993 provides a nonuniversal, unpaid work benefit. In response, several states and localities have adopted the Paid Family Leave policy (PFL) and Paid Sick Leave policy (PSL) over the last two decades. Our objective is to examine the effect of these policies on the probability of personal care provision to older parents. METHODS This study used longitudinal data from the Health and Retirement Study (1998-2020). Difference-in-differences regression models were estimated to examine associations between state- and local-level PFL and PSL mandates and personal care provision to older parents. We analyzed heterogeneous effects by the type of paid leave exposure (provision of job protection with PFL and availability of both PSL and PFL [with or without job protection] concurrently). We also examined results for different population subgroups. FINDINGS PSL implementation was associated with a four- to five-percentage point increase in the probability of personal care provision. These effects were mainly attributable to respondents in states/periods when PSL and PFL were concurrently offered. The strongest effects were found among adult children who were employed at baseline, women, younger, unpartnered, and college educated. PFL implementation by itself was not associated with care provision to parents except when the policy also offered job protection. CONCLUSIONS Paid leave policies have heterogeneous impacts on personal care provision, potentially owing to differences in program features, variation in caregiving needs, and respondent characteristics. Overall, the results indicate that offering paid sick leave and paid family leave, when combined with job protection, could support potential family caregivers.
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Affiliation(s)
| | - Douglas A Wolf
- Maxwell School of Citizenship and Public Affairs, Syracuse University
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3
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Morrissey TW, Castleberry NM, Soni A. The Impacts of New York State's Paid Family Leave Policy on Parents' Sleep and Exercise. Matern Child Health J 2024; 28:1042-1051. [PMID: 38294605 DOI: 10.1007/s10995-024-03899-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVES To assess changes in young parents' health behaviors following implementation of New York State's Paid Family Leave Program (NYSPFL). METHODS We used synthetic control (N = 117,552) and difference-in-differences (N = 18,973) models with data from the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) from 2011 to 2019 to provide individual-level estimates of the effects of NYSPFL on self-reported exercise in the past month and average daily sleep of adults aged 21-30 years living with one or more children under 18 years of age in New York and comparison states. RESULTS Synthetic control model results indicate that the NYSPFL increased the likelihood of exercise in the past month among mothers, single parents, and low-income parents by 6.3-10.3% points (pp), whereas fathers showed a decrease in exercise (7.8 pp). Fathers, single parents, and those with two or more children showed increases in daily sleep between 14 and 21 min per day. CONCLUSIONS FOR PRACTICE State paid family and medical leave laws may provide benefits for health behaviors among young parents with children under 18, particularly those in low-income and single-parent households.
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Affiliation(s)
- Taryn W Morrissey
- Department of Public Administration and Policy, School of Public Affairs, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA.
| | - Neko Michelle Castleberry
- Department of Public Administration and Policy, School of Public Affairs, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
| | - Aparna Soni
- Department of Public Administration and Policy, School of Public Affairs, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
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4
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Kerker BD, Barajas-Gonzalez RG, Rojas NM, Norton JM, Brotman LM. Enhancing immigrant families' mental health through the promotion of structural and community-based support. Front Public Health 2024; 12:1382600. [PMID: 38751580 PMCID: PMC11094290 DOI: 10.3389/fpubh.2024.1382600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
Immigrant communities in the United States are diverse and have many assets. Yet, they often experience stressors that can undermine the mental health of residents. To fully promote mental health and well-being among immigrant communities, it is important to emphasize population-level policies and practices that may serve to mitigate stress and prevent mental health disorders. In this paper, we describe the stressors and stress experienced by immigrant families, using Sunset Park, Brooklyn as an example. We discuss ways to build structures and policies in support of equitable environments that promote mental health at the population level and enable families and their children to thrive.
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Affiliation(s)
- Bonnie D. Kerker
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, United States
| | | | - Natalia M. Rojas
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Jennifer M. Norton
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Laurie M. Brotman
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, United States
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5
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Perry MF, Bui L, Yee LM, Feinglass J. Association Between State Paid Family and Medical Leave and Breastfeeding, Depression, and Postpartum Visits. Obstet Gynecol 2024; 143:14-22. [PMID: 37917931 DOI: 10.1097/aog.0000000000005428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 07/27/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To evaluate the association of state paid family and medical leave policies with the likelihood of breastfeeding, postpartum depression symptoms, and attendance of the postpartum visit. METHODS This was a cross-sectional study that used 2016-2019 data from PRAMS (Pregnancy Risk Assessment Monitoring System) for 43 states and Washington, DC. We describe the association of state paid family and medical leave generosity with rates of breastfeeding, postpartum depression symptoms, and attendance of the postpartum visit. Logistic and Poisson regression models tested the significance of state paid family and medical leave coverage generosity after controlling for individual respondent sociodemographic characteristics, with sensitivity analyses for respondents with deliveries covered by Medicaid insurance. RESULTS Of the 143,131 respondents, representative of an estimated 7,426,725 population, 26.2% lived in eight states and DC with the most generous paid family and medical leave, 20.5% lived in nine states with some paid family and medical leave, and 53.3% lived in 26 states with little or no paid family and medical leave. Overall, 54.8% reported breastfeeding at 6 months or at time of the survey, ranging from 59.5% in the most generous paid family and medical leave states to 51.0% in states with the least paid family and medical leave coverage. Postpartum depression symptoms varied from 11.7% in the most generous states to 13.3% in the least generous states (both P <.001). State differences in postpartum visit attendance rates (90.9% overall) did not differ significantly. After adjusting for respondent characteristics, compared with states with the least paid family and medical leave, breastfeeding was 9% more likely (adjusted incidence rate ratio [aIRR] 1.09, 95% CI, 1.07-1.11) in states with the strongest paid family and medical leave coverage and 32% more likely (aIRR 1.32, 95% CI, 1.25-1.39) in analyses limited to respondents with deliveries covered by Medicaid insurance. A more generous state paid family and medical leave policy was significantly associated with a lower likelihood of postpartum depression symptoms compared with states with the least paid family and medical leave (adjusted odds ratio 0.85, 95% CI, 0.76-0.94) and a modest but significant increase in postpartum visit attendance (aIRR 1.03, 95% CI, 1.01-1.04) among respondents with deliveries covered by Medicaid insurance. CONCLUSION Respondents from states with strong paid family and medical leave had a greater likelihood of breastfeeding and had lower odds of postpartum depression symptoms, with stronger associations among respondents with deliveries covered by Medicaid insurance. Despite major potential health benefits of paid family and medical leave, the United States remains one of the few countries without federally mandated paid parental leave.
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Affiliation(s)
- Madeline F Perry
- Department of Obstetrics and Gynecology, the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, and the Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois
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6
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Goodman JM, Schneider D. Racial/ethnic and gender inequities in the sufficiency of paid leave during the COVID-19 pandemic: Evidence from the service sector. Am J Ind Med 2023; 66:928-937. [PMID: 37640673 PMCID: PMC10684272 DOI: 10.1002/ajim.23533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Access to paid family and medical leave (PFML), including leave to care for a seriously ill loved one or recover from one's own serious illness, conveys health and economic benefits for workers and their families. However, without a national PFML policy, access to paid leave remains limited and unequal. Previous work documenting inequitable access by socioeconomic status and race/ethnicity primarily focuses on parental leave, measures theoretical access to paid leave rather than actual leave uptake, and lacks an accounting for why workers of color and women may have less access to PFML. We extend this literature by looking at leave-taking for medical needs or caregiving among a high-risk population during the COVID-19 pandemic. METHODS We draw on data from 2595 service-sector workers surveyed by the Shift Project in 2020 and 2021 to estimate inequities in leave uptake among workers who experienced qualifying events. We then estimate the relative importance of worker demographic characteristics, qualifying event types (medical vs. caregiving leave), proxies for access to state and employer PFML policies, job characteristics, and ultimately within-firm differences to these gaps. RESULTS Overall, one-fifth of workers reported sufficient leave. Women are significantly more likely than men to report insufficient or no leave. Hispanic and Black workers are more likely to take insufficient or no leave, respectively, but these differences were attenuated when controlling for covariates. CONCLUSIONS The dearth of PFML laws leaves women and workers of color without access to leave that is paid and of sufficient duration when facing a qualifying event.
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Affiliation(s)
- Julia M. Goodman
- Oregon Health & Science University—Portland State University School of Public Health
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7
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Nguyen T, Dennison BA, Radigan A, FitzPatrick E, Zhang W, Ncube B. New York State's Paid Family Leave Program is Associated with More Equitable and Increased Use of Paid Leave Following Childbirth. Matern Child Health J 2023; 27:516-526. [PMID: 36609797 PMCID: PMC9992037 DOI: 10.1007/s10995-022-03510-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This study aimed to assess changes in paid maternity leave before and after New York's (NY) Paid Family Leave (PFL) law went into effect (1/1/2018) and changes in disparities by maternal characteristics. METHODS We used specific data collected on maternity leaves by women who gave birth in 2016-2018 in NY State (outside NY City) participating in the Pregnancy Risk Assessment Monitoring System survey. Multiple logistic regressions were conducted to evaluate the effect of the PFL law on prevalence of paid leave taken by women after childbirth. RESULTS After NY's PFL law went into effect, there was a 26% relative increase in women taking paid leave after childbirth. Use of paid leave after childbirth increased among all racial and ethnic groups. The increases were greater among Black non-Hispanic or other race non-Hispanic women, compared to white non-Hispanic women, suggesting that NY's law was associated with more equitable use of paid leave following childbirth. CONCLUSIONS FOR PRACTICE Wider implementation and greater utilization of paid maternity leave policies would promote health equity and help reduce racial/ethnic disparities in maternal and child health outcomes.
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Affiliation(s)
- Trang Nguyen
- Office of Public Health, New York State Department of Health, Albany, NY, USA. .,Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, USA.
| | - Barbara A Dennison
- Office of Public Health, New York State Department of Health, Albany, NY, USA.,Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, USA.,Department of Health Policy, Management and Behavior, University at Albany School of Public Health, Rensselaer, NY, USA
| | - Anne Radigan
- Office of Public Health, New York State Department of Health, Albany, NY, USA
| | | | - Wei Zhang
- Office of Public Health, New York State Department of Health, Albany, NY, USA
| | - Butho Ncube
- Office of Public Health, New York State Department of Health, Albany, NY, USA.,Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, USA
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Bullinger LR, Klika B, Feely M, Ford D, Merrick M, Raissian K, Rostad W, Schneider W. Paid Family Leave: An Upstream Intervention to Prevent Family Violence. JOURNAL OF FAMILY VIOLENCE 2023; 39:1-11. [PMID: 36685754 PMCID: PMC9843119 DOI: 10.1007/s10896-022-00486-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Purpose Family violence imposes tremendous costs on victims and society. Rarely are policies focused on the primary prevention of family violence. Given the prevalence of family violence-including child maltreatment and intimate partner violence (IPV)-during the perinatal period, policies targeting this vulnerable time period may be successful in primary prevention. Paid family leave (PFL) programs provide income-replacement during particularly stressful family events, such as the birth of a child. Method In this commentary, we describe the conceptual links between PFL, child maltreatment, and IPV, suggesting that PFL may be a promising strategy for the primary prevention of child maltreatment and IPV. Results There is emerging evidence that policies targeting the early years of life may reduce child maltreatment and IPV. Conclusion Addressing the concrete and economic challenges faced by caregivers is one promising strategy for the prevention of family violence.
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Affiliation(s)
| | - Bart Klika
- Prevent Child Abuse America, Chicago, IL USA
| | | | - Derek Ford
- University of Virginia, Charlottesville, VA USA
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9
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Heshmati A, Honkaniemi H, Juárez SP. The effect of parental leave on parents' mental health: a systematic review. Lancet Public Health 2023; 8:e57-e75. [PMID: 36603912 DOI: 10.1016/s2468-2667(22)00311-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/04/2022] [Accepted: 11/16/2022] [Indexed: 01/05/2023]
Abstract
Mental health disorders during the post-partum period are a common morbidity, but parental leave might help alleviate symptoms by preventing or reducing stress. We aim to summarise available evidence on the effect of different types of parental leave on mental health outcomes among parents. For this systematic review, we searched Ovid MEDLINE, Web of Science, PsycINFO, CINAHL, and Scopus from database inception to Aug 29, 2022, for peer-reviewed, quantitative studies written in English. We included studies if the exposure was postnatal parental leave; a relevant comparison group was present (eg, paid vs unpaid leave); and if indicators related to general mental health, including depression, anxiety, stress, and suicide, for either parent were evaluated or recorded at any time after childbirth. The Review is registered with PROSPERO (registration number CRD42021227499). Of the 3441 records screened, 45 studies were narratively synthesised. Studies were done in high-income countries, and they examined generosity by any parental leave (n=5), benefit amount (n=13), and leave duration (n=31). 38 studies were of medium or high quality. Improved mental health was generally observed among women (referred to as mothers in this Review) with more generous parental leave policies (ie, leave duration and paid vs unpaid leave). For example, increased duration of leave was generally associated with reduced risk of poor maternal mental health, including depressive symptoms, psychological distress and burnout, and lower mental health-care uptake. However, the association between fathers' leave and paternal mental health outcomes was less conclusive as was the indirect effect of parental leave use on partners' mental health.
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Affiliation(s)
- Amy Heshmati
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Helena Honkaniemi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden
| | - Sol P Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden
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10
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Goodman JM, Richardson DM, Dow WH. Racial and Ethnic Inequities in Paid Family and Medical Leave: United States, 2011 and 2017-2018. Am J Public Health 2022; 112:1050-1058. [PMID: 35728032 DOI: 10.2105/ajph.2022.306825] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To examine racial and ethnic inequities in paid family and medical leave (PFML) access and the extent to which these inequities are mediated by employment characteristics. Methods. We used data from the 2011 and 2017-2018 American Time Use Survey in the United States to describe paid leave access by race/ethnicity. We present unadjusted models, models stratified by policy-targetable employment characteristics, and adjusted regression models. Results. We found that 54.4% of non-Hispanic White workers reported access to PFML in 2017-2018 but that access was significantly lower among Asian, Black, and Hispanic workers. Inequities were strongest among private-sector and nonunionized workers. Leave access improved slightly between 2011 and 2017-2018, but the inequity patterns were unchanged. Conclusions. We observed large and significant racial and ethnic inequities in access to PFML that were only weakly mediated by job characteristics. PFML has a range of health benefits for workers and their families, but access remains limited and inequitable. Public Health Implications. Our findings suggest that broad PFML mandates (such as those in other high-income countries) may be needed to substantially narrow racial and ethnic gaps in paid leave access. (Am J Public Health. 2022;112(7):1050-1058. https://doi.org/10.2105/AJPH.2022.306825).
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Affiliation(s)
- Julia M Goodman
- Julia M. Goodman and Dawn M. Richardson are with the Oregon Health and Science University and Portland State University School of Public Health, Portland. William H. Dow is with the School of Public Health, University of California, Berkeley
| | - Dawn M Richardson
- Julia M. Goodman and Dawn M. Richardson are with the Oregon Health and Science University and Portland State University School of Public Health, Portland. William H. Dow is with the School of Public Health, University of California, Berkeley
| | - William H Dow
- Julia M. Goodman and Dawn M. Richardson are with the Oregon Health and Science University and Portland State University School of Public Health, Portland. William H. Dow is with the School of Public Health, University of California, Berkeley
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11
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Condon EM, Barcelona V, Ibrahim BB, Crusto CA, Taylor JY. Racial Discrimination, Mental Health, and Parenting Among African American Mothers of Preschool-Aged Children. J Am Acad Child Adolesc Psychiatry 2022; 61:402-412. [PMID: 34153495 PMCID: PMC8683578 DOI: 10.1016/j.jaac.2021.05.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/08/2021] [Accepted: 06/11/2021] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Indirect exposure to racism experienced by a caregiver (ie, vicarious racism) is associated with poor outcomes for children, but mechanisms of vicarious racism transmission are poorly understood. The purpose of this study was to examine the relationship between experiences of racial discrimination and parenting among African American mothers and to identify psychological mediators and moderators of this relationship. METHOD African American mothers (N = 250) with young children (mean age = 3.7 years old) reported on perceived racial discrimination (Race-Related Events Scale), parenting (Parenting Stress Index, Parenting Styles and Dimensions Questionnaire), coping (Coping Strategies Index), and mental health (Stress Overload Scale, Beck Depression Inventory). Multivariable linear regression was used to examine associations between perceived racial discrimination and parenting and to test coping as a moderator of these relationships. Ordinary least-squares regression-based path analysis with bootstrapping was used to examine mediation by stress overload and depressive symptoms. RESULTS At least one experience of racial discrimination was reported by 57% of women. Experiences of racial discrimination were associated with increased parenting stress (β = 0.69, p = .02), and this relationship was mediated by stress overload (95% CI [0.35, 1.09]) and depressive symptoms (95% CI [0.27, 1.18]). Racial discrimination was not associated with parenting styles, and coping strategies largely did not moderate the relationships examined. CONCLUSION Racial discrimination has harmful intergenerational effects on African American children and families. Systemic-level interventions are needed, including adoption of policies to promote racial justice and eliminate structural racism in the United States. Future research on coping strategies specific to racism-related stress is needed to inform approaches to intervention.
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Affiliation(s)
| | | | | | | | - Jacquelyn Y. Taylor
- Center for Research on People of Color, Columbia University School of Nursing, New York
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12
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Rapp KS, Volpe VV, Hale TL, Quartararo DF. State-Level Sexism and Gender Disparities in Health Care Access and Quality in the United States. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:2-18. [PMID: 34794351 DOI: 10.1177/00221465211058153] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In this investigation, we examined the associations between state-level structural sexism-a multidimensional index of gender inequities across economic, political, and cultural domains of the gender system-and health care access and quality among women and men in the United States. We linked administrative data gauging state-level gender gaps in pay, employment, poverty, political representation, and policy protections to individual-level data on health care availability, affordability, and quality from the national Consumer Survey of Health Care Access (2014-2019; N = 24,250). Results show that higher state-level sexism is associated with greater inability to access needed health care and more barriers to affording care for women but not for men. Furthermore, contrary to our hypothesis, women residing in states with higher state-level sexism report better quality of care than women in states with lower levels of sexism. These findings implicate state-level sexism in perpetuating gender disparities in health care.
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Hu C, Tkebuchava T. Health in All Laws: A better strategy for global health. J Evid Based Med 2022; 15:10-14. [PMID: 35416434 DOI: 10.1111/jebm.12469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 03/18/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Chunsong Hu
- Department of Cardiovascular Medicine, Hospital of Nanchang University, Jiangxi Academy of Medical Science, Nanchang University, Nanchang, Jiangxi, China
| | - Tengiz Tkebuchava
- Office of the President/CEO, Boston TransTec, LLC, Boston, Massachusetts
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14
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Goodman JM, Williams C, Dow WH. Racial/Ethnic Inequities in Paid Parental Leave Access. Health Equity 2021; 5:738-749. [PMID: 34909544 PMCID: PMC8665807 DOI: 10.1089/heq.2021.0001] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Severe racial inequities in maternal and infant health in the United States are caused by the many forms of systemic racism. One manifestation of systemic racism that has received little attention is access to paid parental leave. The aim of this article is to characterize racial/ethnic inequities in access to paid leave after the birth of a child. Methods: We analyzed data on women who were employed during pregnancy (n=908) from the Bay Area Parental Leave Study of Mothers, a survey of mothers who gave birth in the San Francisco Bay Area in 2016–2017. We examined differences in access to government- and employer-paid leave, the duration of leave taken, and the percent of usual pay received while on leave. To explore these differences, we further examined knowledge of paid leave benefits and sources of information. Results: Non-Hispanic (NH) black and Hispanic women had significantly less access to paid leave through their employers or through government programs than their NH white and Asian counterparts. Relative to white women, Asian, Hispanic, and black women received 0.9 (p<0.05), 2.0 (p<0.01), and 3.6 (p<0.01) fewer weeks, respectively, of full-pay equivalent pay during their parental leaves. Despite inequitable access to paid leave, the duration of parental leave taken did not differ by race/ethnicity. Conclusions: Inequitable access to paid parental leave through both employers and government programs exacerbates racial inequities at birth. This form of structural racism could be addressed by policies expanding access to paid leave.
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Affiliation(s)
- Julia M Goodman
- Oregon Health and Science University-Portland State University School of Public Health, Portland, Oregon, USA
| | - Connor Williams
- University of California-Berkeley School of Public Health, Berkeley, California, USA
| | - William H Dow
- University of California-Berkeley School of Public Health, Berkeley, California, USA
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15
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Goodman JM, Schneider D. The association of paid medical and caregiving leave with the economic security and wellbeing of service sector workers. BMC Public Health 2021; 21:1969. [PMID: 34724922 PMCID: PMC8558760 DOI: 10.1186/s12889-021-11999-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Service-sector workers in the U.S. face extremely limited access to paid family and medical leave, but little research has examined the consequences for worker wellbeing. Our objective was to determine whether paid leave was associated with improved economic security and wellbeing for workers who needed leave for their own serious health condition or to care for a seriously ill loved one. METHODS We analyzed data collected in 2020 by the Shift Project from 11,689 hourly service-sector workers across the US. We estimated the impact of taking paid leave on economic insecurity and wellbeing relative to taking unpaid leave, no leave, or not experiencing a need to take leave. RESULTS Twenty percent of workers needed medical or caregiving leave in the reference period. Workers who took paid leave reported significantly less difficulty making ends meet, less hunger and utility payment hardship, and better sleep quality than those who had similar serious health or caregiving needs but did not take paid leave. CONCLUSIONS Access to paid leave enables front line workers to take needed leave from work while maintaining their financial security and wellbeing.
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Affiliation(s)
- Julia M Goodman
- Oregon Health & Science University, Portland State University School of Public Health, Portland, OR, USA.
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Condon EM, Londono Tobon A, Jackson B, Holland ML, Slade A, Mayes L, Sadler LS. Maternal Experiences of Racial Discrimination, Child Indicators of Toxic Stress, and the Minding the Baby Early Home Visiting Intervention. Nurs Res 2021; 70:S43-S52. [PMID: 34173377 PMCID: PMC8405547 DOI: 10.1097/nnr.0000000000000529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Racism is a significant source of toxic stress and a root cause of health inequities. Emerging evidence suggests that exposure to vicarious racism (i.e., racism experienced by a caregiver) is associated with poor child health and development, but associations with biological indicators of toxic stress have not been well studied. It is also unknown whether two-generation interventions, such as early home visiting programs, may help to mitigate the harmful effects of vicarious racism. OBJECTIVE The purpose of this study was to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and to test whether relationships are moderated by prior participation in Minding the Baby (MTB), an attachment-based early home visiting intervention. METHODS Ninety-seven maternal-child dyads (n = 43 intervention dyads, n = 54 control dyads) enrolled in the MTB Early School Age follow-up study. Mothers reported on racial discrimination using the Experiences of Discrimination Scale. Child indicators of toxic stress included salivary biomarkers of inflammation (e.g., C-reactive protein, panel of pro-inflammatory cytokines), body mass index, and maternally reported child behavioral problems. We used linear regression to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and included an interaction term between experiences of discrimination and MTB group assignment (intervention vs. control) to test moderating effects of the MTB intervention. RESULTS Mothers identified as Black/African American (33%) and Hispanic/Latina (64%). In adjusted models, maternal experiences of racial discrimination were associated with elevated salivary interleukin-6 and tumor necrosis factor-α levels in children, but not child body mass index or behavior. Prior participation in the MTB intervention moderated the relationship between maternal experiences of discrimination and child interleukin-6 levels. DISCUSSION Results of this study suggest that racism may contribute to the biological embedding of early adversity through influences on inflammation, but additional research with serum markers is needed to better understand this relationship. Improved understanding of the relationships among vicarious racism, protective factors, and childhood toxic stress is necessary to inform family and systemic-level intervention.
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Tait M, Bogucki C, Baum L, Franklin Fowler E, Niederdeppe J, Gollust S. Paid family leave on local television news in the United States: Setting the agenda for policy reform. SSM Popul Health 2021; 14:100821. [PMID: 34095428 PMCID: PMC8164082 DOI: 10.1016/j.ssmph.2021.100821] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/04/2022] Open
Abstract
Access to paid family and medical leave (“paid leave”) has bipartisan support among lawmakers in the United States, but the issue remains stalled on the public policy agenda. The U.S. does not currently have a federal paid leave policy, and unpaid leave—guaranteed by the Family and Medical Leave Act of 1993—is all that is available to the majority of workers. In this study, we examine the content of local television news as representations of, and potential influence on, paid leave policy agendas. To do so, we analyze the extent to which local television news coverage describes the problem of lack of employment leave, and whether coverage highlights public policy as a solution. We use data from local television stations affiliated with the four major networks (ABC, NBC, CBS, and FOX) in all 210 media markets in the U.S. during a period pre-pandemic, from October 2018 until July 2019. We find that 64% of local television news coverage related to paid leave discussed the issue in the context of public policy. Coverage more often cited early-stage policy actions such as a policy idea - reflected in 40% of stories discussing stages of public policymaking – or the introduction of a bill – detailed in 22% of these stories. This coverage aligns with actual policy activity at the state-level during the same time period. News coverage infrequently included elements that could shape public understanding of paid leave as a population health issue, such as including health-related sources of providers or researchers. Policymakers, advocates, and researchers looking to advance public support for paid leave should consider efforts to use local television news as a vehicle to present health and policy-relevant information to broad segments of the public and set the agenda for policy reform. Local tv news coverage of paid family leave was infrequent. Relevant coverage highlighted policy details and included political sources. Political sources in coverage potentially politicized the issue for viewers. Details of the health equity implications of policy were largely absent. Local tv news outlets are important to prioritize in research dissemination.
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Affiliation(s)
- Margaret Tait
- Department of Health Policy and Management, University of Minnesota School of Public Health, D305 Mayo Building, MMC 729 420 Delaware St. SE, Minneapolis, MN 55455 USA
| | - Colleen Bogucki
- Wesleyan Media Project Wesleyan University, 45 Wyllys Ave. Middletown, CT 06459, USA
| | - Laura Baum
- Wesleyan Media Project Wesleyan University, 45 Wyllys Ave. Middletown, CT 06459, USA
| | - Erika Franklin Fowler
- Wesleyan Media Project Wesleyan University, 45 Wyllys Ave. Middletown, CT 06459, USA.,Department of Government Wesleyan University, 45 Wyllys Ave. Middletown, CT 06459 USA
| | - Jeff Niederdeppe
- Department of Communication Cornell University, 476 Mann Library Building Ithaca, NY 14853 USA
| | - Sarah Gollust
- Department of Health Policy and Management, University of Minnesota School of Public Health, D305 Mayo Building, MMC 729 420 Delaware St. SE, Minneapolis, MN 55455 USA
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